Networked system for interactive communication and remote monitoring of individuals

ABSTRACT

A system for remotely monitoring an individual. The system includes a server system for generating a script program from a set of queries. The script program is executable by a remote apparatus that displays information and/or a set of queries to the individual through a user interface. Responses to the queries that are entered through the user interface together with individual identification information are sent from the remote apparatus to the server system across a communication network. The server system also includes an automated answering service for providing a series of questions from a stored set of questions for an individual at the remote apparatus to respond to, storing responses to each provided question in the series of questions and providing a service based on the individual&#39;s response to the questions.

STATEMENT OF RELATED CASES

This application is a continuation of U.S. application Ser. No.11/150,301, filed Jun. 13, 2005, which is a continuation of U.S.application Ser. No. 09/658,209, filed Sep. 8, 2000, now U.S. Pat. No.6,968,375, which is a continuation in part of U.S. application Ser. No.09/300,856, filed Apr. 28, 1999, now U.S. Pat. No. 6,368,273, which is adivisional application of application Ser. No. 08/946,341, filed Oct. 7,1997, now U.S. Pat. No. 5,997,476, which is a continuation in part ofapplication Ser. No. 08/847,009, filed Apr. 30, 1997, now U.S. Pat. No.5,897,493 which, in turn claims the benefit of Provisional applications60/041,746 and 60/041,751, both filed Mar. 28, 1997.

This application is also related to: (i) U.S. Pat. Nos. 5,985,559 and6,101,478, both continuations in part of U.S. Pat. No. 5,897,493; (ii)U.S. Pat. No. 6,248,065, a divisional of U.S. Pat. No. 5,997,476; (iii)U.S. Pat. No. 6,270,455, a continuation in part of U.S. Pat. No.5,997,476; (iv) U.S. Pat. No. 6,381,577, which is a continuation of U.S.Pat. No. 6,101,478; (v) abandoned applications Ser. No. 09/531,237, acontinuation in part of U.S. Pat. Nos. 6,368,273 and 09/378,188 acontinuation of U.S. Pat. No. 5,985,559; (vi) co-pending applicationSer. No. 10/279,749, which is a continuation in part of application Ser.No. 10/233,296, which is a continuation in part of co-pendingapplication Ser. No. 09/665,442, which is a continuation in part of U.S.Pat. No. 6,381,577, and (vii) co-pending applications (a) Ser. No.11/093,167, (b) Ser. No. 11/093,168, (c) Ser. No. 11/132,427 and (d)Ser. No. 11/150,301. Each of the patents and/or applications referencedare incorporated by reference.

FIELD OF THE INVENTION

The present invention relates generally to communication systems forremote monitoring of individuals, and in particular to a networkedsystem for remotely monitoring individuals and for communicatinginformation to the individuals through the use of script programs.

BACKGROUND OF THE INVENTION

In the United States alone, over 100 million people have chronic healthconditions, accounting for an estimated $700 billion in annual medicalcosts. In an effort to control these medical costs, many healthcareproviders have initiated outpatient or home healthcare programs fortheir patients. The potential benefits of these programs areparticularly great for chronically ill patients who must treat theirdiseases on a daily basis. However, the success of these programs isdependent upon the ability of the healthcare providers to monitor thepatients remotely to avert medical problems before they becomecomplicated and costly. Further, success requires compliance with theprogram, which is often dependent on providing messages or otherreminders to patients so that they will stay with the program.Unfortunately, no convenient and cost effective monitoring system existsto accomplish these objectives. While these problems are particularlyacute for the poor and the elderly, all demographic groups couldsignificantly benefit from remote communication and monitoring systems.

Prior attempts to monitor patients remotely have included the use ofpersonal computers and modems to establish communication betweenpatients and healthcare providers, either directly or via an Internetsite. However, computers are too expensive to give away and the patientswho already own computers are only a fraction of the total population.

Other attempts to monitor patients remotely have included the use ofmedical monitoring devices with built-in modems. Examples of suchmonitoring devices include blood glucose meters, respiratory flowmeters, and heart rate monitors. While these devices can be quitesuccessful, their multimedia capabilities are often limited. Inaddition, many patients simply may prefer to interact with a device theyare more familiar with, such as a television.

Prior attempts to monitor patients remotely have also included the useof interactive telephone or video response systems. Such interactivesystems are disclosed in U.S. Pat. No. 5,390,238 issued to Kirk et al.on Feb. 14, 1995, U.S. Pat. No. 5,434,611 issued to Tamura on Jul. 18,1995, and U.S. Pat. No. 5,441,047 issued to David et al. on Aug. 15,1995. One disadvantage of these systems is that they either require apatient to call in to a central facility to be monitored or require thecentral facility to call the patient according to a rigid monitoringschedule.

If the patients are required to call the central facility, only thecompliant patients will actually call regularly to be monitored.Non-compliant patients will typically wait until an emergency situationdevelops before contacting their healthcare provider, thus defeating thepurpose of the monitoring system. If the central facility calls eachpatient according to a monitoring schedule, it is intrusive to thepatient's life and resistance to the monitoring grows over time.Further, it is difficult to identify each patient uniquely using thesesystems. Moreover, these systems are generally incapable of collectingmedical data from monitoring devices, such as blood glucose meters,respiratory flow meters, or heart rate monitors.

As such, there exists a need for a simple and inexpensive system forremotely monitoring patients and for easily communicating information tothe patients. There is also a need to encourage patient's compliancewith a prescribed treatment plan.

SUMMARY

The present invention provides a system for remotely interacting with anindividual. The system includes a server, a remote interface device forassigning in the server a set of queries to be answered by theindividual, a remotely programmable apparatus for interacting with theindividual and a broadcaster in communication with the server and theremotely programmable apparatus.

By using the entertainment medium of interactive television with itsability to receive a large bandwidth of data, the present invention canmore easily communicate interactive entertaining/educational informationto potential and existing patients. The interactive nature of thereceived data makes it easy for a user to access interactive programsrelated to corresponding entertainment/advertisement content or relatedto user adherence to a predefined regimen.

In accordance with another aspect of the present invention, an answeringservice sends a series of questions as voice communication from a storedset of questions to the remote apparatus for the individual to respondto, when the voice communication button is activated. The answeringservice stores responses to each provided question in the series ofquestions and provides a service based on the individual's response tothe questions. The provided service is communication with a health careprofessional or a service provider. Also, the answering service includesa speech recognition component for receiving spoken responses to theseries of questions and a speech synthesis component for making the setof queries into a series of questions.

In accordance with yet another aspect of the present invention, theremotely programmable apparatus includes an appliance component forproviding appliance functionality. The appliance component is an alarmclock, a kitchen appliance, or an entertainment device.

In accordance with still another aspect of the present invention, theremotely programmable apparatus includes a monitoring component forproducing measurements of a physiological condition of the individual.

BRIEF DESCRIPTION OF THE DRAWINGS

The foregoing aspects and many of the attendant advantages of thisinvention will become more readily appreciated as the same becomesbetter understood by reference to the following detailed description,when taken in conjunction with the accompanying drawings, wherein:

FIG. 1 is a block diagram of networked system formed in accordance witha first embodiment of the present invention;

FIG. 2 is a block diagram illustrating the interaction of the componentsof the system of FIG. 1;

FIG. 3 is a perspective view of a remotely programmable apparatus of thesystem of FIG. 1;

FIG. 4 is a block diagram illustrating the components of the apparatusof FIG. 3;

FIG. 5 is a script entry screen according to the preferred embodiment ofthe invention;

FIG. 6A is a listing of a sample script program according to thepreferred embodiment of the invention;

FIG. 6B is a continuation of the listing of FIG. 6A;

FIG. 7 is a script assignment screen according to the preferredembodiment of the invention FIG. 8 is a sample query appearing on theapparatus of FIG. 1A-D;

FIG. 9 is a sample prompt appearing on the display of the apparatus ofFIG. 3;

FIG. 10 is a sample report displayed on a workstation of the system ofFIG. 1A-D;

FIG. 11A is a flow chart illustrating the steps included in a monitoringapplication executed by the server of FIG. 1A-D according to the presentinvention;

FIG. 11B is a continuation of the flow chart of FIG. 11A;

FIG. 12A is a flow chart illustrating the steps included in the scriptprogram of FIG. 6A-6B;

FIG. 12B is a continuation of the flow chart of FIG. 12;

FIG. 13 is a perspective view of a remotely programmable apparatusaccording to an embodiment of the present invention;

FIG. 14 is a sample prompt appearing on a display of the apparatus ofFIG. 13;

FIG. 15 is a block diagram illustrating the components of the apparatusof FIG. 13;

FIG. 16 is a schematic block diagram illustrating the interaction of theserver of FIG. 1A-D with the apparatus of FIG. 3 according to anotherembodiment of the present invention;

FIG. 17 is a first sample message appearing on the display of theapparatus of FIG. 3;

FIG. 18 is a second sample message appearing on the display of theapparatus of FIG. 3;

FIG. 19 is a script entry screen according to an embodiment of thepresent invention;

FIGS. 20 and 21 are block diagrams of alternate embodiments of thepresent invention;

FIG. 22 is a flow chart illustrating the process performed by the systemof FIG. 21; and

FIGS. 23 and 24 are example broadcast programming presentations with anincluded script program.

DETAILED DESCRIPTION

The present invention provides a system and method for remotelymonitoring individuals and for increasing individual use of healthprograms. In a first embodiment of the invention, the individuals arepatients and the system is used to collect data relating to the healthstatus of the patients. However, it is to be understood that theinvention is not limited to remote monitoring of patients. The systemand method of the invention may be used for any type of remotemonitoring and program adherence application. The invention may also beimplemented as an automated messaging system for communicatinginformation to individuals, as will be discussed in an alternativeembodiment below.

A first embodiment of the invention is illustrated in FIG. 1A and 2-12.Referring to FIG. 1, a networked system 16 includes a server 18 and aworkstation 20 connected to the server 18 through a communicationnetwork 24. The server 18 is preferably a world wide web server and thecommunication network 24 is preferably the Internet. It will be apparentto one skilled in the art that the server 18 may comprise a singlestand-alone computer or multiple computers distributed throughout anetwork. The workstation 20 is preferably a personal computer, remoteterminal, or web TV unit connected to the server 18 via the Internet.The workstation 20 functions as a remote interface for entering in theserver 18 messages and queries to be communicated to the patients.

The system 16 also includes multiple remotely programmable apparatus,such as first and second apparatuses 26 for monitoring multiplepatients. Each apparatus 26 is designed to interact with a patient inaccordance with script programs received from the server 18. Eachapparatus 26 is in communication with the server 18 through thecommunication network 24, preferably the Internet. Alternatively, eachapparatus 26 may be placed in communication with the server 18 viawireless communication networks, cellular networks, telephone networks,satellite networks or any other network which allows each apparatus 26to exchange data with the server 18. It is to be understood that thesystem 16 may include any number of remotely programmable apparatusesfor monitoring any number of patients.

In the preferred embodiment, each patient to be monitored is alsoprovided with a monitoring device 28. The monitoring device 28 isdesigned to produce measurements of a physiological condition of thepatient, record the measurements, and transmit the measurements to thepatient's remotely programmable apparatus through a standard connectioncable 30. Examples of suitable monitoring devices 28 include bloodglucose meters, respiratory flow meters, blood pressure cuffs,electronic weight scales, and pulse rate monitors. Such monitoringdevices are well known in the art. The specific type of monitoringdevice 28 provided to each patient is dependent upon the patient'sdisease or health treatment needs. For example, diabetes patients areprovided with a blood glucose meter for measuring blood glucoseconcentrations, asthma patients are provided with respiratory flowmeters for measuring peak flow rates, obesity patients are provided withweight scales, etc.

FIG. 2 shows the server 18, the workstation 20, and the apparatus 26 ingreater detail. The server 18 includes a database 38 for storing scriptprograms 40. The script programs 40 are executed by each apparatus 26,to communicate queries and messages to a patient, receive responses 42to the queries, collect monitoring device measurements 44, and totransmit responses 42 and measurements 44 to the server 18. The database38 is designed to store responses 42 and measurements 44. The database38 further includes a look-up table 46. The table 46 contains a list ofthe patients to be monitored, and for each patient, a unique patientidentification code and a respective pointer to one or more scriptprograms 40 assigned to the patient. Each remotely programmableapparatus 26 is designed to execute assigned script programs 40 receivedfrom the server 18. The script programs 40 may include queries, remindermessages, informational statements, useful quotations, or otherinformation of benefit to the patient. See Appendix A for example scriptprograms.

FIG. 3-4 show the structure of a remotely programmable apparatus 26according to the preferred embodiment. Referring to FIG. 3, theapparatus 26 includes a housing 62. The housing 62 is sufficientlycompact to enable the apparatus 26 to be hand-held and carried by apatient. The apparatus 26 also includes a display 64 for displayingqueries and prompts to the patient. In the preferred embodiment, thedisplay 64 is a liquid crystal display (LCD).

The apparatus 26 includes five user input buttons 70A, 70B, 70C, 70D and70E that are located on the same side of the apparatus 26 as the display64. The user input buttons 70A-D are for entering in the apparatus 26responses 42 to the queries and prompts. In the preferred embodiment,the user input buttons 70A-D are momentary contact push buttons. Inalternative embodiments, user input buttons 70A-D may be replaced byswitches, keys, a touch sensitive display screen, or any other datainput device.

The user input button 70E is a emergency or other services button and ispreferably red, but may be of any size, shape, or color that drawsspecial visual or tactile attention to the user. The services providedby the user input button 70E are described in more detail below.

Three monitoring device jacks 68A, 68B, and 68C are located on a surfaceof housing 62. The device jacks 68A-C are for connecting the apparatus26 to a number of monitoring devices 28, such as blood glucose meters,respiratory flow meters, or blood pressure cuffs (not shown in FIG. 3).The apparatus 26 also includes a modem jack 66 for connecting theapparatus 26 to a telephone jack through a standard connection cord (notshown). The apparatus 26 further includes a visual indicator, such as alight emitting diode (LED) 74. The LED 74 is for visually notifying thepatient that he or she has unanswered queries stored in the apparatus26.

FIG. 4 is a schematic block diagram illustrating the components of theapparatus 26 in greater detail. The apparatus 26 includes amicroprocessor 76 and a memory 80 connected to the microprocessor 76.The memory 80 is preferably a non-volatile memory, such as a serialEEPROM. The memory 80 stores script programs 40 received from the server18, measurements 44 received from the monitoring device 28, responses 42to queries. The microprocessor 76 also includes built-in read onlymemory (ROM), which stores firmware for controlling the operation of theapparatus 26. The firmware includes a script interpreter used by themicroprocessor 76 to execute the script programs 40. The scriptinterpreter interprets script commands, which are executed by themicroprocessor 76. Specific techniques for interpreting and executingscript commands in this manner are well known in the art.

The microprocessor 76 is preferably connected to memory 80 using astandard two-wire interface. The microprocessor 76 is also connected tothe user input buttons 70, the LED 74, a clock 84, and a display driver82. The clock 84 indicates the current date and time to themicroprocessor 76. For clarity of illustration, clock 84 is shown as aseparate component, but is preferably built into the microprocessor 76.The display driver 82 operates under the control of the microprocessor76 to display information on the display 64. The microprocessor 76 ispreferably a PIC 16C65 processor. The modem 86 is connected to atelephone jack 22 through the modem jack 66. The modem 86 is forexchanging data between the server 18 and the processor 76 through thecommunication network 24. The data includes the script programs 40 whichare received from the server 18 as well as the responses 42 to queries,the device measurements 44, the script identification codes, and thepatient's unique identification code, which the modem 86 transmits tothe server 18. The modem 86 is preferably a complete 28.8 K modemcommercially available from Cermetek, although any suitable modem may beused. The processor 76 also includes a component that connects to thetelephone jack 22 and a microphone 88 and a speaker 89, thereby allowingtelephone calls to be processed.

The device interface 90 is connected to the device jacks 68A, 68B, and68C. The device interface 90 is for interfacing with a number ofmonitoring devices 28, such as blood glucose meters, respiratory flowmeters, blood pressure cuffs, weight scales, or pulse rate monitors,through device jacks 68A-C.

The device interface 90 operates under the control of the microprocessor76 to collect measurements 44 from the monitoring devices 28 and tooutput the measurements to the microprocessor 76 for storage in thememory 80. In the preferred embodiment, the interface 90 is a standardRS232 interface. For simplicity of illustration, only one deviceinterface 90 is shown in FIG. 4. However, in alternative embodiments,the apparatus 26 may include multiple device interfaces to accommodatemonitoring devices that have different connection standards.

Referring again to FIG. 2, the server 18 includes a monitoringapplication 48. The monitoring application 48 is a controlling softwareapplication executed by the server 18 to perform the various functionsdescribed below. The application 48 includes a script generator 50, ascript assignor 52, and a report generator 54. The script generator 50is designed to generate the script programs 40 from script informationentered through the workstation 20. The script information is enteredthrough a script entry screen 56. In the preferred embodiment, scriptentry screen 56 is implemented as a web page on the server 18. Theworkstation 20 includes a web browser for accessing the web page toenter the script information.

FIG. 5 illustrates the script entry screen 56 as it appears on theworkstation 20. The screen 56 includes a script name field 92 forspecifying the name of a script program to be generated. The screen 56also includes entry fields 94 for entering a set of queries to beanswered by a patient. Each entry field 94 has corresponding responsechoice fields 96 for entering response choices for the query. The screen56 further includes check boxes 98 for selecting a desired monitoringdevice 28, such as a blood glucose meter, respiratory flow meter, orblood pressure cuff, from which to collect measurements 44.

The screen 56 additionally includes a connection time field 100 forspecifying a prescribed connection time at which each apparatus 26executing the script is to establish a subsequent communication link tothe server 18. The connection time is preferably selected to be the timeat which communication rates are the lowest, such as 3:00 AM. The screen56 also includes a CREATE SCRIPT button 102 for instructing scriptgenerator 50 to generate a script program 40 from the informationentered in screen 56. The screen 56 further includes a CANCEL button 104for canceling the information entered in screen 56.

In the preferred embodiment, each script program 40 created by scriptgenerator 50 conforms to the standard file format used on UNIX systems.In the standard file format, each command is listed in the upper caseand followed by a colon. Every line in the script program 40 isterminated by a linefeed character {LF}, and only one command is placedon each line. The last character in the script program 40 is a UNIX endof file character {EOF}. Table 1 shows an exemplary listing of scriptcommands used in the preferred embodiment of the invention. TABLE 1SCRIPT COMMANDS Command Description CLS: {LF} Clear the display. ZAP:{LF} Erase from memory the last set of query responses recorded. LED:b{LF} Turn the LED on or off, where b is a binary digit of 0 or 1. Anargument of 1 turns on the LED, and an argument of 0 turns off the LED.DISPLAY: Display the text following the DISPLAY command. {chars}{LF}INPUT: Record a button press. The m's represent a button mmmm {LF} maskpattern for each of the four input buttons. Each m contains an “X” fordisallowed buttons or an “0” for allowed buttons. For example, INPUT:0X0X{LF} allows the user to press either button #1 or #3. WAIT: {LF}Wait for any one button to be pressed, then continue executing thescript program. COLLECT: Collect measurements from the monitoring devicedevice{LF} specified in the COLLECT command. The user is preferablyprompted to connect the specified monitoring device to the apparatus andpress a button to continue. NUMBER: Assign a script identification codeto the script aaaa{LF} program. The script identification code from themost recently executed NUMBER statement is subsequently transmitted tothe server along with the query responses and device measurements. Thescript identification code identifies to the server which script programwas most recently executed by the remote apparatus. DELAY: t{LF} Waituntil time t specified in the DELAY command, usually the prescribedconnection time. CONNECT: Perform a connection routine to establish a{LF} communication link to the server, transmit the patientidentification code, query responses, device measurements, and scriptidentification code to the server, and receive and store a new scriptprogram. When the server instructs the apparatus to disconnect, thescript interpreter is restarted, allowing the new script program toexecute.

The script commands illustrated in Table 1 are representative of thepreferred embodiment and are not intended to limit the scope of theinvention. After consideration of the ensuing description, it will beapparent to one skilled in the art many other suitable scriptinglanguages and sets of script commands may be used to implement theinvention.

The script generator 50 preferably stores a script program templatewhich it uses to create each script program 40. To generate a scriptprogram 40, the script generator 50 inserts into the template the scriptinformation entered in the screen 56. For example, FIG. 6A-6B illustratea sample script program 40 created by the script generator 50 from thescript information shown in FIG. 5.

The script program 40 includes display commands to display the queriesand response choices entered in fields 94 and 96, respectively. Thescript program 40 also includes input commands to receive responses 42to the queries. The script program 40 further includes a collect commandto collect device measurements 44 from the monitoring device 28specified in the check boxes 98. The script program 40 also includescommands to establish a subsequent communication link to the server 18at the connection time specified in field 100 FIG. 5. The steps includedin the script program 40 are also shown in the flow chart of FIG.12A-12B and will be discussed in the operation section below.

Referring again to FIG. 2, the script assignor 52 is used to assignscript programs 40 to the patients. The script programs 40 are assignedin accordance with script assignment information entered throughworkstation 20. The script assignment information is entered through ascript assignment screen 57, which is preferably implemented as a webpage on the server 18.

FIG. 7 illustrates a sample script assignment screen 57 as it appears onworkstation 20. The screen 57 includes check boxes 106 for selecting ascript program 40 to be assigned, and check boxes 108 for selecting thepatients to whom the script program is to be assigned. The screen 57also includes an ASSIGN SCRIPT button 112 for entering the assignments.When button 112 is pressed, the script assignor 52 creates and storesfor each patient selected in check boxes 108 a respective pointer to thescript program 40 selected in the check boxes 106. Each pointer isstored in the patient look-up table 46 of the database 38. The screen 57further includes an ADD SCRIPT button 110 for accessing the script entryscreen and a DELETE SCRIPT button 114 for deleting a script program 40.

Referring again to FIG. 2, the report generator 54 is designed togenerate a patient report 58 from the responses 42 and the devicemeasurements 44 received in the server 18. The patient report 58 isdisplayed on the workstation 20. FIG. 10 shows a sample patient report58 produced by the report generator 54 for a selected patient. Thepatient report 58 includes a graph 116 of the device measurements 44received from the patient, as well as a listing of the responses 42received from the patient. Specific techniques for writing a reportgenerator program to display data in this manner are well known in theart.

The operation of the preferred embodiment is illustrated in FIG. 1-12.FIG. 11A is a flow chart illustrating steps included in the monitoringapplication executed by the server 18. FIG. 11B is a continuation of theflow chart of FIG. 11A. In step 202, the server 18 determines if newscript information has been entered through the script entry screen 56.If new script information has not been entered, the server 18 proceedsto step 206. If new script information has been entered, the server 18proceeds to step 204.

As shown in FIG. 5, the script information includes a set of queries,and for each of the queries, corresponding response choices. The scriptinformation also includes a selected monitoring device type from whichto collect device measurements 44. The script information furtherincludes a prescribed connection time for each apparatus to establish asubsequent communication link to the server 18. The script informationis generally entered in the server 18 by a healthcare provider, such asthe patients' physician or case manager. Of course, any person desiringto communicate with the patients may also be granted access to theserver 18 to create and assign script programs 40. Further, it is to beunderstood that system 16 may include any number of remote interfacesfor entering script generation and script assignment information in theserver 18.

In step 204, the script generator 50 generates a script program from theinformation entered in the screen 56. The script program is stored inthe database 38. Steps 202 and 204 are preferably repeated to generatemultiple script programs, e.g., a script program for diabetes patients,a script program for asthma patients, etc. Each script programcorresponds to a respective one of the sets of queries entered throughthe script entry screen 56. Following step 204, the server 18 proceedsto step 206.

In step 206, the server 18 determines if new script assignmentinformation has been entered through the assignment screen 57. If newscript assignment information has not been entered, the server 18proceeds to step 210. If new script assignment information has beenentered, the server 18 proceeds to step 208. As shown in FIG. 7, thescript programs are assigned to each patient by selecting a scriptprogram through check boxes 106, selecting the patients to whom theselected script program is to be assigned through check boxes 108, andpressing the ASSIGN SCRIPT button 112. When button 112 is pressed, thescript assignor 52 creates for each patient selected in the check boxes108 a respective pointer to the script program selected in the checkboxes 106. In step 208, each pointer is stored in the look-up table 46of the database 38. Following step 208, the server 18 proceeds to step210.

In step 210, the server 18 determines if any of the apparatuses areremotely connected to the server. Each patient to be monitored ispreferably provided with his or her own remotely programmable apparatus,which has the patient's unique identification code, stored therein. Eachpatient is thus uniquely associated with a respective one of theapparatuses. If none of the apparatuses is connected, the server 18proceeds to step 220. If an apparatus is connected, the server 18receives from the apparatus the patient's unique identification code instep 212. In step 214, the server 18 receives from the apparatus 26 thequery responses 42, device measurements 44, and script identificationcode recorded during execution of a previously assigned script program.The script identification code identifies to the server 18 which scriptprogram was executed by the apparatus to record the query responses 42and device measurements 44. The responses, device measurements, andscript identification code are stored in the database 38.

In step 216, the server 18 uses the patient identification code toretrieve from the table 46 the pointer to the script program assigned tothe patient. The server 18 then retrieves the assigned script programfrom the database 38. In step 218, the server 18 transmits the assignedscript program to the patient's remotely programmable apparatus throughthe communication network 24. Following step 218, the server 18 proceedsto step 220.

In step 220, the server 18 determines if a patient report request hasbeen received from the workstation 20. If no report request has beenreceived, the server 18 returns to step 202. If a report request hasbeen received for a selected patient, the server 18 retrieves from thedatabase 38 the measurements 44 and query responses 42 last receivedfrom the patient, step 222. In step 224, the server 18 generates anddisplays the patient report 58 on the workstation 20. As shown in FIG.10, the report 58 includes the device measurements 44 and queryresponses 42 last received from the patient. Following step 224, theserver 18 returns to step 202.

FIG. 12A-12B illustrate the steps included in the script programexecuted by the apparatus 26. Before the script program is received, theapparatus 26 is initially programmed with the patient's uniqueidentification code and the script interpreter used by microprocessor 76to execute the script program. The initial programming may be achievedduring manufacture or during an initial connection to the server 18.Following initial programming, the apparatus 26 receives from the server18 the script program assigned to the patient associated with theapparatus 26. The script program is received by the modem 86 through afirst communication link and stored in the memory 80.

In step 302, microprocessor 76 assigns a script identification code tothe script program and stores the script identification code in thememory 80. The script identification code is subsequently transmitted tothe server 18 along with the query responses 42 and the devicemeasurements 44 to identify to the server 18 which script program wasmost recently executed by apparatus 26. In step 304, the microprocessor76 lights LED 74 to notify the patient that he or she has unansweredqueries stored in the apparatus 26. The LED 74 preferably remains lituntil the patient answers the queries. In step 306, the microprocessor76 erases from the memory 80 the last set of query responses recorded.

In step 308, the microprocessor 76 prompts the patient by displaying onthe display 64 “ANSWER QUERIES NOW? PRESS ANY BUTTON TO START”. In step310, the microprocessor 76 waits until a reply to the prompt is receivedfrom the patient. When a reply is received, the microprocessor 76proceeds to step 312. In step 312, the microprocessor 76 executessuccessive display and input commands to display the queries andresponse choices on the display 64 and to receive responses to thequeries.

FIG. 8 illustrates a sample query and its corresponding response choicesas they appear on the display 64 The response choices are positioned onthe display 64 such that each response choice is located proximate arespective one of input buttons 70A-D. In the preferred embodiment, eachresponse choice is displayed immediately above a respective input button70A-D. The patient presses the button 70A-D corresponding to his or herresponse. The microprocessor 76 stores each response in the memory 80.

In steps 314-318, the microprocessor 76 executes commands to collect thedevice measurements 44 from a selected the monitoring device 28. Thescript program specifies the selected monitoring device from which tocollect the measurements. In step 314, the microprocessor 76 prompts thepatient to connect the selected monitoring device 28, for example ablood glucose meter, to one of device jacks 68A-C. A sample prompt isshown in FIG. 9. In step 316, the microprocessor 76 waits until a replyto the prompt is received from the patient. When a reply is received,the microprocessor 76 proceeds to step 318. In step 318, themicroprocessor 76 collects device measurements 44 from the monitoringdevice 28 through the interface 90. The measurements 44 are stored inthe memory 80.

In step 320, the microprocessor 76 prompts the patient to connect theapparatus 26 to the telephone jack 22 so that the apparatus 26 mayconnect to the server 18 at the prescribed connection time. In step 322,the microprocessor 76 waits until a reply to the prompt is received fromthe patient. When a reply is received, the microprocessor 76 turns offthe LED 74 in step 324. In step 326, the microprocessor 76 waits untilit is time to connect to the server 18. The microprocessor 76 comparesthe connection time specified in the script program to the current timeoutput by the clock 84.

In step 328, the microprocessor 76 establishes a subsequentcommunication link between the apparatus 26 and the server 18 throughthe modem 86 and the communication network 24. If the connection failsfor any reason, the microprocessor 76 repeats step 328 to get asuccessful connection. In step 330, the microprocessor 76 transmits thedevice measurements 44, query responses 42, script identification code,and patient identification code stored in the memory 80 to the server 18through the subsequent communication link. In step 332, themicroprocessor 76 receives through the communication network 24 a newscript program from the server 18. The new script program is stored inthe memory 80 for subsequent execution by the microprocessor 76.Following step 332, the script program ends.

One advantage of the monitoring system of the present invention is thatit allows each patient to select a convenient time to respond to thequeries, so that the monitoring system is not intrusive to the patient'sschedule. A second advantage of the monitoring system is that it incursvery low communications charges because each remote apparatus connectsto the server 18 at times when communication rates are lowest. Moreover,the cost to manufacture each remote the apparatus 26 is very lowcompared to personal computers or internet terminals, so that themonitoring system is highly affordable.

A third advantage of the monitoring system is that it allows eachapparatus 26 to be programmed remotely through script programs 40.Patient surveys, connection times, display prompts, selected monitoringdevices, patient customization, and other operational details of eachapparatus 26 may be easily changed by transmitting a new script program40 to apparatus 26. Moreover, each script program 40 may be easilycreated and assigned by remotely accessing the server 18 through theInternet. Thus, the invention provides a powerful, convenient, andinexpensive system for remotely monitoring a large number of patients.

FIG. 13-15 illustrate a second embodiment of the invention in which eachremotely programmable apparatus includes all of the functionality of thefirst embodiment described above while also including speech recognitionand speech synthesis functionality. FIG. 13 shows a perspective view ofthe remotely programmable apparatus 27 according to the secondembodiment. The apparatus 27 includes a speaker 72 for audiblycommunicating queries and prompts to the patient. The apparatus 27 alsoincludes a microphone 118 for receiving spoken responses to the queriesand prompts. The apparatus 27 may optionally include a display 64 fordisplaying prompts to the patient, as shown in FIG. 14.

FIG. 15 is a schematic block diagram illustrating the components of theapparatus 27 in greater detail. The apparatus 27 is similar in design tothe apparatus 26 of the preferred embodiment except that the apparatus27 includes an audio processor chip 120 in place of the microprocessor76. The audio processor chip 120 is preferably an RSC-164 chipcommercially available from Sensory Circuits Inc. of 1735 N. FirstStreet, San Jose, Calif. 95112.

The audio processor chip 120 has a microcontroller 122 for executingscript programs received from the server 18. A memory 80 is connected tothe microcontroller 122. Memory 80 stores the script programs and ascript interpreter used by the microcontroller 122 to execute the scriptprograms. The memory 80 also stores measurements received from themonitoring device 28, responses to the queries, script identificationcodes, and the patient's unique identification code.

The audio processor chip 120 also has built in speech synthesisfunctionality for synthesizing queries and prompts to a patient throughthe speaker 72. For speech synthesis, the chip 120 includes a digital toanalog converter-(DAC) 142 and an amplifier 144. The DAC 142 and theamplifier 144 drive the speaker 72 under the control of themicrocontroller 122.

The audio processor chip 120 further has built in speech recognitionfunctionality for recognizing responses spoken into the microphone 118.Audio signals received through the microphone 118 are converted toelectrical signals and sent to a preamp and gain control circuit 128.The preamp and gain control circuit 128 is controlled by an automaticgain control circuit 136, which is in turn controlled by themicrocontroller 122. After being amplified by the preamp 128, theelectrical signals enter the chip 120 and pass through a multiplexer 130and an analog to digital converter (ADC) 132. The resulting digitalsignals pass through a digital logic circuit 134 and entermicrocontroller 122 for speech recognition.

The audio processor chip 120 also includes a RAM 138 for short-termmemory storage and a ROM 140, which stores programs executed by themicrocontroller 122 to perform speech recognition and speech synthesis.The chip 120 operates at a clock speed determined by a crystal 126. Thechip 120 also includes a clock 84 that provides the current date andtime to the microcontroller 122. As in the preferred embodiment, theapparatus 27 includes an LED 74, display driver 82, modem 86, and deviceinterface 90, all of which are connected to the microcontroller 122.

The operation of the second embodiment is similar to the operation ofthe preferred embodiment except that queries, response choices, andprompts are audibly communicated to the patient through the speaker 72rather than being displayed to the patient on the display 64. Theoperation of the second embodiment also differs from the operation ofthe preferred embodiment in that responses to the queries and promptsare received through the microphone 118 rather than through user inputbuttons.

The script programs of the second embodiment are similar to the scriptprogram shown in FIG. 6A-6B, except that each display command isreplaced by a speech synthesis command and each input command isreplaced by a speech recognition command. The speech synthesis commandsare executed by the microcontroller 122 to synthesize the queries,response choices, and prompts through speaker 72. The speech recognitioncommands are executed by the microcontroller 122 to recognize responsesspoken into microphone 118.

For example, to ask the patient how he or she feels and record aresponse, the microcontroller 122 first executes a speech synthesiscommand to synthesize through the speaker 72 “How do you feel? Pleaseanswer with one of the following responses: very bad, bad, good, or verygood.” Next, the microcontroller 122 executes a speech recognitioncommand to recognize the response spoken into the microphone 118. Therecognized response is stored in the memory 80 and subsequentlytransmitted to the server. Other than the differences described, theoperation and advantages of the second embodiment are the same as theoperation and advantages of the preferred embodiment described above.

Although the first and second embodiments focus on querying individualsand collecting responses to the queries, the system of the invention isnot limited to querying applications. The system may also be used simplyto communicate messages to the individuals. FIG. 16-19 illustrate athird embodiment in which the system is used to perform this automatedmessaging function. In the third embodiment, each script programcontains a set of statements to be communicated to an individual ratherthan a set of queries to be answered by the individual Of course, itwill be apparent to one skilled in the art that the script programs mayoptionally include both queries and statements.

The third embodiment also shows how the queries and statements may becustomized to each individual by merging personal data with the scriptprograms, much like a standard mail merge application. As mentionedabove, the individual may be identified for selection of individualizedinformation either through an individual identification code associatedwith the remote apparatus 26 and stored in memory 80. Referring to FIG.16, personal data relating to each individual is preferably stored inthe look-up table 46 of the database 38. By way of example, the data mayinclude each individual's name, the name of each individual's physician,test results, appointment dates, or any other desired data. As in thepreferred embodiment, the database 38 also stores generic scriptprograms 40 created by the script generator 50.

The server 18 includes a data merge program 55 for merging the datastored in table 46 with generic script programs 40. The data mergeprogram 55 is designed to retrieve selected data from table 46 and toinsert the data into statements in generic script programs 40, thuscreating custom script programs 41. Each custom script program 41contains statements that are customized to an individual. For example,the statements may be customized with the individual's name, testresults, etc. Examples of such customized statements are shown in FIG.17-18.

The operation of the third embodiment is similar to the operation of thepreferred embodiment except that the script programs are used tocommunicate messages to the individuals rather than to query theindividuals. Each message is preferably a set of statements. Referringto FIG. 19, the statements may be entered in the server 18 through thescript entry screen 56, just like the queries of the preferredembodiment.

Each statement preferably includes one or more insert commandsspecifying data from table 46 to be inserted into the statement. Theinsert commands instruct the data merge program 55 to retrieve thespecified data from the database 38 and to insert the data into thestatement. For example, the insert commands shown in FIG. 19 instructthe data merge program 55 to insert a physician name, an appointmentdate, a patient name, and a test result into the statements. As in thepreferred embodiment, each statement may also include one or moreresponse choices, which are entered in fields 96.

Following entry of the statements and response choices, CREATE SCRIPTbutton 102 is pressed. When the button 102 is pressed, the scriptgenerator 50 generates a generic script program from the informationentered in the screen 56. The generic script program is similar to thescript program shown in FIG. 6A-6B, except that the display commandsspecify statements to be displayed rather than queries. Further, thestatements include insert commands specifying data to be inserted intothe script program. As in the preferred embodiment, multiple scriptprograms are preferably generated, e.g., a generic script program fordiabetes patients, a generic script program for asthma patients, etc.The generic script programs are stored in the database 38.

Following generation of the generic script programs, the server 18receives script assignment information entered through the scriptassignment screen 57. As shown in FIG. 7, the script programs areassigned by first selecting one of the generic script programs throughthe check boxes 106, selecting individuals through the check boxes 108,and pressing the ASSIGN SCRIPT button 112. When the button 112 ispressed, the data merge program 55 creates a custom script program 41for each individual selected in check boxes 108.

Each custom script program 41 is preferably created by using theselected generic script program as a template. For each individualselected, the data merge program 55 retrieves from the database 38 thedata specified in the insert commands. Next, the data merge program 55inserts the data into the appropriate statements in the generic scriptprogram 40 to create a custom script program 41 for the individual. Eachcustom script program 41 is stored in the database 38.

As each custom script program 41 is generated for an individual, thescript assignor 52 assigns the script program 41 to the individual. Thisis preferably accomplished by creating a pointer to the custom scriptprogram and storing the pointer with the individual's uniqueidentification code in the table 46. When the individual's remotelyprogrammable apparatus connects to the server 18, the server 18 receivesfrom the remotely programmable apparatus 26 the individual's uniqueidentification code. The server 18 uses the unique identification codeto retrieve from the table 46 the pointer to the custom script programassigned to the individual. Next, the server 18 retrieves the assignedscript program from the database 38 and transmits the script program tothe individual's remotely programmable apparatus 26 through thecommunication network 24.

The apparatus receives and executes the script program. The execution ofthe script program is similar to the execution described in thepreferred embodiment, except that statements are displayed to theindividual rather than queries. FIG. 17-18 illustrate two samplestatements as they appear on the display 64. Each statement includes aresponse choice, preferably an acknowledgment such as “OK”. Afterreading a statement, the individual presses the button 70A-Dcorresponding to the response choice to proceed to the next statement.Alternatively, the script program may specify a period of time that eachstatement is to be displayed before proceeding to the next statement.The remaining operation of the third embodiment is analogous to theoperation of the preferred embodiment described above.

Although it is presently preferred to generate a custom script program41 for each individual as soon as script assignment information isreceived for the individual, it is also possible to wait until theindividual's apparatus 26 connects to the server 18 before generatingthe custom script program 41. This is accomplished by creating andstoring a pointer to the generic script program 40 assigned to theindividual, as previously described in the preferred embodiment. Whenthe individual's apparatus 26 connects to the server 18, the data mergeprogram 55 creates a custom script program 41 for the individual fromthe generic script program 40 assigned to the individual. The customscript program 41 is then sent to the individual's apparatus 26 forexecution.

Alternate Embodiments

In an alternate embodiment, when the user or patient (the terms user andpatient are used interactively) activates the user input button 70E(hereinafter the red button) a command signal is sent to the processor76. The processor 76 dial a preset phone number according to the commandsignal. The preset phone number is that of an answering service at theserver 18 or at a workstation 20. The answering service identifies thepatient or user associated with the remote apparatus 26 that generatedthe call based on an identifier sent with the call and user informationstored in memory in the database (similar to caller ID). The system(server 18 or workstation 20) that receives the call then retrievespatient information with previous patient/user responses stored at theserver's database 38, within memory at the workstation 20, or at someother remotely located storage site. The retrieved patient informationis displayed to a live person who is in telephonic communication withthe patient. This allows the patient to be placed in immediate contactwith a person who has displayed before them the patient's personalhealth information or other patient historical information. The personreceiving the call provides effective communication with the patient,because of the ability to view pertinent information.

In an alternate embodiment, an automated answering service is therecipient of the call made by the remote apparatus 26. The automatedanswering service asks a series of questions according to the retrievedpatient information in order to triage the patient toward differentactions depending upon the situation. The patient information alsoincludes previous patient interactions with the automated answeringservice.

The system receiving the call process patient responses according to thecontent associated with the question asked. Content is one of thefollowing categories: symptoms; behavior; knowledge. The categoriesinclude such things as requests for service or product orders. In oneexample, the automated answering service asks “do you have difficultybreathing? press the red button if you are.” If the patient then pressesthe red button, the call is forwarded to a case manager or a nurse oncall.

In another example, red button selection is associated with a requestfor service. When the red button is pressed, the automated answeringservice asks “do you need someone to change your bed? press the redbutton if yes.” If the patient presses the red button, a home careagency coordinating ancillary daily activity services is notified or isforwarded the call. Other service companies, such as transport companiesor concierge service companies, are other possible recipients offorwarded calls depending what actions are available to the patients.

The automated answering service is dynamically adaptable based onprevious interactions with the automated answering service. For example,the past couple of times the patient activated the red button andanswered the question(s), the patient was connected to an emergencyhealth care worker. If the worker determined through review questions ofthe patient's present condition, maybe information generated by themonitoring device sent over the network 24 to a workstation operated bythe worker, and retrieved patient information that no emergency existed,the worker records this situation into the patient's records. If thepatient's record includes a number of false alarms that exceed apredetermined limit over a period of time, the automated answeringservice reprograms itself so that the next time the patient activatesthe red button the patient is directly connected to a live person thatis designated for non-emergency patient interaction or to otherquestions that direct the patient to the person designated fornon-emergency patient interaction. This frees-up emergency healthcareworkers from dealing with someone who has a history of not needing theirexpertise.

FIGS. 20 and 21 illustrate alternate embodiments of the inventionillustrated in FIG. 1. In FIG. 20, the remote apparatus 26 is a personalcomputer including a processor and a user interface, e.g., display,keyboard, mouse, or other input and output devices (not all shown), thatreceives the script program, processes the script program and presentsthe script program for user interaction. For example, the script programrequires that the personal computer present an image of a stand-aloneremote apparatus 350, such as the Health Buddy™, produced by Health HeroNetwork, Inc., on the display. The user then interacts with thedisplayed image of the stand-alone remote apparatus by operating theuser interface(s) of the personal computer to select displayedresponses. The displayed image of the stand-alone remote apparatuspresents a virtual image with the same functionality as the apparatuses26 and 27, as described above in FIGS. 3 and 13. It can be appreciatedto those of ordinary skill in the art that the system of FIG. 20provides all or part of the functionality of the apparatuses shown inFIGS. 3 and 13, but does it on a personal computer.

FIG. 21 includes all the components of the FIG. 1 and a digitaltelevision network 36 in communication with the server 18 and the remoteapparatus 26. The remote apparatus 26 of FIG. 21 is an interactivetelevision system that includes a processing unit 33, such as asatellite broadcast receiving, set-top processor with OpenTV signalprocessing software, a display 34, such as a television set, and a userinterface 35, such as a remote control. The remote apparatus 26, throughthe processing unit 33, is coupled to the communication network 24, thedigital television network 36 and the monitoring device 28.

The processing unit 33 includes a CPU, memory and embedded software forreceiving and processing both digital entertainment and advertisementcontent and digital script programs. Also, the processing unit 33 allowsthe user to view the entertainment and advertisement content, such astelevision programming, and interact with (i.e., respond to) the scriptprograms. The script program(s) sent from the server 18 are viewable onthe display 34 as they would appear on the display 64 of apparatus 26 orare viewed on a portion of the display 34. For example, the questionwith options shown in FIG. 8 would appear on the display 34. The usermakes a selection of one of the choices by using the user interface 35,i.e., giving voice commands that are processed by a voice recognitionsystem, controlling and activating a cursor, etc. Example methods ofmaking a selection are to control a cursor icon on the display screen ofthe display 34 and activate the cursor icon when it is co-located withone of the choices, to assign different keyboard keys are designated asa different one of the displayed choices. Another method is to have theuser interface include voice actuation software for processing uservoice commands that request selection of a desired choice.

With respect to this invention, a “broadcast” includes any form ofdelivering the content from a source to many viewers, includingtransmission over the airwaves or via cable, the Internet, aclosed-circuit network, or other means of communication. A “broadcast”does not require multiple persons to watch at once, but rather caninclude multiple individual and independent viewings, such as in theform of video on demand or access to web pages. Moreover, the term“broadcast” may include a single tailored transmission from a source toa single intended viewer. Accordingly, while a “broadcast” may include atransmission from one point to multiple recipients, it is not limited tothat case. Likewise, with respect to this invention, a “broadcast” is“transmitted” in any of the above forms.

The processing unit 33 is a multimedia processor that receivestransmitted broadcast programs from a digital broadcast network 36 via acommunication link, such as a satellite or cable link. The processingunit 33 also transmits as well as receives data via the communicationnetwork 24. In addition, the multimedia processor has expansion ports tosupport additional user interface and other devices, such as keyboards,joysticks, trackballs, and to accept add-on circuits for enhanced sound,video, or processing performance.

FIG. 22 is an example for illustrative purposes only of a method forincreasing user use of script programs by allowing the user to quicklyaccess the script program during viewing of an entertainment oradvertisement program in an interactive TV system. FIG. 22 illustrates aprocess performed by the system shown in FIG. 21. At block 400, theserver 18 generates an interactive script program. In an alternateembodiment, the script program is fully or partially created at anotherremotely coupled computer, such as workstation 20, and added tomultimedia content, then the script program and multimedia content issent to the server 18 In one embodiment, the script program isspecialized for a specific user according to a health care professionalrequest or to a predefined health regimen based on user profileinformation. In an alternate embodiment the script program is generatedin relation to entertainment or advertisement content that it will laterbe broadcasted with. Next, at block 402, the generated script program iscombined with digital produced entertainment or advertisement content,i.e., a multimedia presentation, to create digital broadcastprogramming. The digital broadcast programming is then broadcasted ortransmitted over the chosen communication link, block 406. At block 408,the processing unit 33 receives and processes the digital broadcastprogramming then presents the entertainment or advertisement content andthe script program. The processing unit 33 as directed by softwareinstructions previously imbedded in the processing unit 33, includedwith the digital broadcast programming or a combination of bothprocesses the digital broadcast programming by determining its contentand how that content is to be presented on the display 34. For example,the processing unit 33 determines if the script program is to bereferenced by an icon over the entertainment content or displayed on aportion of the display with the entertainment content. As part of thepresentation from block 408 the user is informed of any script programincluded in the broadcast programming, block 410. Then, at block 426,the user is presented with the script program after the user selects oractivates the indication, e.g., an icon. Lastly, at block 428, the userinteracts with the script program by responding to any queries andinputting any requested measurements or other responses. The interactionwith the script program is similar to that described above for thesystem of FIG. 1. In another embodiment, the script program is presentedin conjunction with the entertainment or advertisement content withoutrequiring the user to select or activate an indicator.

FIGS. 23 and 24 are example images presented on the displays 34 in thesystem illustrated in FIG. 22. FIG. 23 illustrates a screen shot of abroadcast program 250 that includes entertainment content 252, such as avideo program on heart surgery, and an icon 254. The icon 254 indicatesthat a script program is available for the viewer. In order for theviewer to access the script program, the viewer selects the icon 254.The program broadcasted from the broadcast network 24 may have includedan entire script program or just a portion of a script program. If theentire script program were included with the broadcast, selection of theicon 254 would begin execution of the script program that was received.However, if only a portion of the script program was received and, forexample, that portion only required that the icon 254 be displayed withthe entertainment content 252, selection of the icon 254 sends a signalthrough a back channel, i.e., the link to the communication network 24,to the server 18. The sent signal is a request for the rest of or justmore of the script program to be sent to the apparatus 26 either throughbroadcast network 36 or communication network 24.

FIG. 24 illustrates a screen shot of a broadcast program 250 thatincludes entertainment content 252 and a section that presents a scriptprogram image 256. In this example the viewer can interact with thescript program image 256 while simultaneously viewing the entertainmentcontent 252. As in FIG. 22 above, the script program may be fully orpartially received and processed by the processing unit 33. And again,if it has only been partially received, viewer interaction at apredetermined spot in the displayed interaction process automaticallyinitiates a request through the back channel to the server 18 for therest of the script program.

Because the broadcast program 250 is a digital broadcast, it can bereadily appreciated by those of ordinary skill in the art of digitalinteractive television, that the entertainment content may be pauseduntil viewer completion of the script program. The script program whichcan be sent with an initial broadcast program or during presentation ofa previously delivered broadcast program that is being presented on thedisplay may also include instructions to pause the entertainment contentuntil viewer completion of the script program at which time theentertainment program resumes. For example, the viewer's/patient'sdoctor creates a message at the workstation 20 requesting that thepatient as soon as possible send blood pressure measurement readings.This message is generated as a new script program at the server 18. Theserver 18 then sends the new script program to the broadcast network 36.The broadcast network 36 includes hardware and/or software mechanismsfor saving the new script program for inclusion with the next patientrequested entertainment or advertisement content to be sent to thepatient in the case where the patient is not presently viewing abroadcast from the broadcast network 36 or for just broadcasting thescript program alone. If the patient is presently viewing entertainmentor advertisement content received from the broadcast network 36, the newscript program is received, processed and presented to the patient bythe apparatus 26. The received new script program may includeinstructions to pause the presently viewed entertainment oradvertisement content.

If the script program is specified for a particular patient, the server18 or broadcast network 36 encodes the script program for that patient.The apparatus of that patient includes a decoding component within theprocessing unit 33 for decoding the encoded script program received withthe broadcast program. For example, the script program includes a weighthistory chart of the patient. The present invention wants only thepatient corresponding to this weight history chart to have viewingaccess. Therefore, it is encoded for transmission and encoded only bythe corresponding patient's apparatus 26.

It can be appreciated to one of ordinary skill in the art that thisdecision, as with the other flow diagram decisions, can be an inherentdecision in the processing of the received entertainment/advertisementprogramming and script program.

The embodiments of FIGS. 20 and 21 may also be implemented without anyentertainment or advertisement content and perform the functions as tothose that illustrated and described for FIG. 1.

The script programs or entertainment/advertisement programming can bedesigned for education and training of users. For example, the scriptprogram or information content could show a user, such as a patient, howto effectively use a medical treatment device. Also, the script programor information content could describe to users, such as doctors, nursesor anyone other professional, different treatment styles, plans or newmedication.

A wide variety of information may be collected, delivered and analyzedin accordance with the present invention. For example, abandoned U.S.patent application Ser. No. 09/378,188 which is a continuation of U.S.Pat. No. 5,985,559, and unassigned U.S. patent application attorneydocket No. HERO-1-1089 which is a continuation of U.S. patentapplication Ser. No. 09/041,809 (the text of which are herebyincorporated by reference) discusses information related to diseasecauses, treatments, and cures. Script programs include a set of queriesfor requesting data on lifestyle, environment, behavior, drugcompliance, drug response over time, and other aspects. This data isthen analyzed to identify trends and establish subgroups with similarresponses.

Individuals' behavioral and environmental information in conjunctionwith their gene sequence information is analyzed to find drug candidatesand drug targets. Individuals previously designated as having a highrisk for developing a particular disease are each given an apparatus 26.Queries related to the individuals' behavior and environment areincluded in a script program sent from a server 18 to the apparatus 26or from a server 18 to the apparatus 26 through a broadcast network 36.The individuals' responses are sent back to the server 18. The processof collecting individuals' information can take place over a long periodof time to ensure accurate data and to allow researchers to observeprogression of the disease. A data mining program on the server analyzesthe individuals' behavioral and environmental information, as well astheir gene sequence information. Differences in gene sequenceinformation, or in behavioral and environmental factors betweenindividuals who show a severe disease phenotype and those who show amild severe disease phenotype can then be distinguished and used todevelop new drug candidates, targets, or general treatments.

Genetic testing allows an individual to determine whether or not he orshe has a predisposition to a certain disease. The degree ofexpressivity of a certain disease will be determined in part by anindividuals environment and lifestyle. The environment and lifestyleinformation is retrieved from responses to queries sent from the server18 to the apparatus 26 or from the server 18 to the apparatus 26 throughthe broadcast network 36. The present invention interprets a patient'sgene sequence information and his or her environment and lifestyle tocome up with a personalized prognosis. This procedure can be repeatedmany times over the course of a disease state to monitor a patient'scondition. In addition, disease-causing pathogens can also have theirgenes sequenced. Using these sequences in combination with informationabout a patient's environment and lifestyle, the present invention comesup with a personalized treatment plan, ideally to eliminate thepathogen. It is also possible to use the procedure described above tomonitor the course of the disease-state produced by a pathogen. Finally,a genotype-to-phenotype map or database can be constructed fordeveloping better treatments and aiding in research.

Although the above description contains many specificities, these shouldnot be construed as limitations on the scope of the invention but merelyas illustrations of some of the presently preferred embodiments. Manyother embodiments of the invention are possible. For example, thescripting language and script commands shown are representative of thepreferred embodiment. It will be apparent to one skilled in the art manyother scripting languages and specific script commands may be used toimplement the invention.

Moreover, the invention is not limited to the specific applicationsdescribed. The system and method of the invention have many otherapplications both inside and outside the healthcare industry. Forexample, pharmaceutical manufacturers may apply the system in theclinical development and post marketing surveillance of new drugs, usingthe system as an interactive, on-line monitoring tool for collectingdata on the efficacy, side effects, and quality of life impact of thedrugs. Compared to the current use of labor-intensive patientinterviews, the system provides a fast, flexible, and cost effectivealternative for monitoring the use and effects of the drugs.

The system may also be used by home healthcare companies to enhance theservice levels provided to customers, e.g., panic systems, sleepsurveillance, specific monitoring of disease conditions, etc.Alternatively, the system may be used to monitor and optimize theinventory of home-stationed health supplies. As an example, the systemmay be connected to an appropriate measuring device to optimize timingof oxygen tank delivery to patients with chronic obstructive pulmonarydisease (COPD).

The system and method of the invention also have many applicationsoutside the healthcare industry. For example, the system may be used forremote education over the Internet, facilitating educationalcommunication with children or adult trainees who lack access tosophisticated and expensive computer equipment. The system may also beused by law enforcement officers to perform on-line surveillance ofindividuals on probation or parole.

In an alternate embodiment, the software and hardware components of anyone of the remote apparatuses 26 or 27 are incorporated directly into amonitoring device. This allows a patient to only have to interact withone device for their entire health monitoring needs.

Further, the invention has numerous applications for gathering data fromremotely located devices. For example, the system may be used to collectdata from smart appliances, such as identification check systems.Examples of appliances that are used as smart appliances arerefrigerator, telephone, stove, clock radio, VCR, or any otherelectrical or non-electrical device including the monitoring device 28.The smart appliance includes some or all of the components of the remoteapparatuses 26 or 27 as illustrated in FIGS. 4 and 15. The smartappliance with the necessary hardware or software components providesall the interactive capabilities described and shown for remoteapparatuses 26 or 27, see FIGS. 8-12, 14, 17 and 18. In one embodiment,the assigned scripts are in the form of a recorded voice that is sentover the communication network (e.g., voice over IP) to the appliance orremote apparatus. Also, the user responds to the voice scripts throughactivation of buttons according to instructions in the voice scripts orby verbally responding to the voice scripts. The verbal responses by theuser are sent to the server or workstation over the communicationnetwork (e.g., voice over IP). The server or workstation includes avoice recognition component for interpreting the user's verbalresponses, records the response and determines the next question orrequest (verbal or otherwise) to be sent to the user according to theresponses. Live voice communication is also possible between the remoteapparatus and the server or workstation over the communication network.

Also, the monitoring device includes a communication component forallowing the monitoring device to send data directly to the server 18.The server 18 then sends the monitoring device data to the patient'ssmart appliance for display to the patient. In an alternate additionalsetup, the monitoring device sends the data to the smart apparatus.

Alternatively, the system may be applied to the remote monitoring offacilities, including safety and security monitoring, or toenvironmental monitoring, including pollution control and pipelinemonitoring. Many other suitable applications of the invention will beapparent to one skilled in the art.

Therefore, the scope of the invention should be determined not by theexamples given, but by the appended claims and their legal equivalents.

1. A system for remotely monitoring an individual having a high risk ofdeveloping a particular disease, comprising: a first user interface forentering, authoring, selecting, or any combination thereof, a set ofqueries to be answered by the individual and for entering, authoring,selecting, or any combination thereof, corresponding response choicesfor each of the queries, wherein the queries are related to theindividual's behavior, environment, lifestyle, drug compliance, drugresponse over time, symptoms, disease progression, or any combinationthereof; a user script generator connected to the first user interfaceand configured to generate a script program to be executed by a remoteapparatus, wherein the script program includes display commands todisplay the queries and the response choices and input commands toreceive responses to the queries; and one or more databases for storingthe responses received from the remote apparatus and gene sequenceinformation.
 2. The system according to claim 1, further comprising: adata analysis program connected to a second user interface and the oneor more databases and configured to analyze the responses in conjunctionwith the gene sequence information.
 3. The system according to claim 2,wherein said gene sequence information comprises a gene sequence of theindividual.
 4. The system according to claim 2, wherein said genesequence information is obtained through genetic testing of theindividual.
 5. The system according to claim 4, wherein the dataanalysis program is further configured to generate a personalizedprognosis for the individual using the responses in combination with thegene sequence information of the individual.
 6. The system according toclaim 5, wherein collection of responses and analysis of responses incombination with the gene sequence information is repeated over a periodof time.
 7. The system according to claim 6, wherein the period of timecomprises a course of a disease state to monitor a condition of theindividual.
 8. The system according to claim 4, wherein the dataanalysis program is further configured to determine whether theindividual is a candidate for a drug based upon results of analyzing theresponses in conjunction with the gene sequence information.
 9. Thesystem according to claim 4, wherein the data analysis program isfurther configured to determine whether an individual having apredetermined gene profile is a candidate for a drug based upon resultsof analyzing the responses in conjunction with the gene sequenceinformation.
 10. The system according to claim 2, wherein said genesequence information comprises one or more gene sequences of adisease-causing pathogen.
 11. The system according to claim 10, whereinthe data analysis program is further configured to generate apersonalized treatment plan to eliminate said disease-causing pathogenusing the responses in combination with the one or more gene sequencesof the disease-causing pathogen.
 12. The system according to claim 10,wherein the data analysis program is further configured to monitor acourse of a disease-state produced by said disease-causing pathogenusing the responses in combination with the one or more gene sequencesof the disease-causing pathogen.
 13. The system according to claim 10,wherein the data analysis program is further configured to determinewhether the disease-causing pathogen is a target for a drug based uponresults of analyzing the responses in conjunction with the gene sequenceinformation.
 14. The system according to claim 10, wherein the dataanalysis program is further configured to determine whether adisease-causing pathogen having one or more predetermined gene sequencesis a target for a drug based upon results of analyzing the responses inconjunction with the gene sequence information.
 15. The system accordingto claim 1, wherein the one or more databases are further configured forstoring a genotype-to-phenotype map generated using the responses andthe gene sequence information.
 16. The system according to claim 1,further comprising: a data mining program configured to analyze theresponses and the gene sequence information to determine differences ingene sequence information, behavioral factors and environmental factorsbetween individuals showing a severe disease phenotype and individualsshowing a mild disease phenotype.
 17. The system according to claim 1,wherein the one or more databases are further configured for storingmeasurements of a physiological condition of the individual.
 18. Thesystem according to claim 17, wherein the measurements of thephysiological condition of the individual are collected using one ormore monitoring devices comprising a device, multiple devices or acombination of devices selected from the group consisting of a sensorfor measuring a blood-related physiological condition, a sensor formeasuring respiratory flow, a sensor for measuring electrical activityof the individual, a sensor for measuring blood pressure, a sensor formeasuring a weight-related condition and a sensor for measuring aheart-related condition.
 19. A method for remotely monitoring anindividual having a high risk of developing a particular disease,comprising the steps of: (A) generating a script program based on one ormore queries related to the individual's behavior, environment,lifestyle, drug compliance, drug response over time, symptoms, diseaseprogression, or any combination thereof; (B) transmitting the scriptprogram to a remote apparatus, wherein the script program includesdisplay commands to display the queries, input commands to receiveresponses and a transmit command to transmit the responses from theremote apparatus; and (C) receiving and storing the responses.
 20. Themethod according to claim 19, wherein the step of generating the scriptprogram comprises entering, authoring, selecting, or any combinationthereof, the set of queries to be answered by the individual.
 21. Themethod according to claim 19, further comprising the step of: analyzingthe responses in conjunction with gene sequence information.
 22. Themethod according to claim 21, wherein the gene sequence informationcomprises a gene sequence of the individual.
 23. The method according toclaim 21, wherein said gene sequence information is obtained throughgenetic testing of the individual.
 24. The method according to claim 23,further comprising the step of: generating a personalized prognosis forthe individual using the responses in combination with the gene sequenceinformation of the individual.
 25. The method according to claim 24,further comprising the step of: repeatedly performing the stepsaccording to claim 19 over a course of a disease state to monitor acondition of the individual.
 26. The method according to claim 23,further comprising the step of: determining whether the individual is acandidate for a drug based upon results of analyzing the responses inconjunction with the gene sequence information.
 27. The method accordingto claim 23, further comprising the step of: determining whether anindividual having a predetermined gene profile is a candidate for a drugbased upon results of analyzing the responses in conjunction with thegene sequence information.
 28. The method according to claim 21, whereinsaid gene sequence information comprises one or more gene sequences of adisease-causing pathogen.
 29. The method according to claim 28, furthercomprising the step of: personalizing a treatment plan to eliminate saiddisease-causing pathogen using the responses in combination with the oneor more gene sequences of the disease-causing pathogen.
 30. The methodaccording to claim 28, further comprising the step of: monitoring acourse of a disease-state produced by said disease-causing pathogenusing the responses in combination with the one or more gene sequencesof the disease-causing pathogen.
 31. The method according to claim 28,further comprising the step of: determining whether the disease-causingpathogen is a target for a drug based upon results of analyzing theresponses in conjunction with the gene sequence information.
 32. Themethod according to claim 28, further comprising the step of:determining whether a disease-causing pathogen having one or morepredetermined gene sequences is a target for a drug based upon resultsof analyzing the responses in conjunction with the gene sequenceinformation.
 33. The method according to claim 21, further comprisingthe steps of: constructing a genotype-to-phenotype map using theresponses and the gene sequence information.
 34. The method according toclaim 21, further comprising the steps of: data mining the responses andthe gene sequence information to determine differences in gene sequenceinformation, behavioral factors and environmental factors betweenindividuals showing a severe disease phenotype and individuals showing amild disease phenotype.
 35. An apparatus for communicating with acomputer remotely situated from the apparatus, the apparatus comprising:a communication interface for receiving a script program containing aset of queries and response choices from the computer and fortransmitting responses to the set of queries to the computer, whereinthe queries are related to an individual's behavior, environment,lifestyle, drug compliance, drug response over time, symptoms, diseaseprogression, or any combination thereof; a user interface forcommunicating the set of queries and response choices to the individualand for receiving the responses to the set of queries from theindividual; a memory configured to store the script program and theresponses to the set of queries; and a processor connected to thecommunication interface, the user interface, and the memory forexecuting the stored script program, wherein the stored script programwhen executed causes the apparatus to communicate the set of queries tothe individual, to receive the responses to the set of queries from theindividual, and to transmit the responses to the computer.
 36. Theapparatus according to claim 35, further comprising: one or more jacksconfigured to connect the apparatus to one or more monitoring devicesfor obtaining measurements of a physiological condition of theindividual; and a device interface connected between the one or morejacks and the processor, wherein the processor is configured to receivethe measurements from the one or more monitoring devices, store themeasurements in the memory, and transmit the measurements to thecomputer via the communication interface.
 37. The apparatus according toclaim 36, wherein the device interface is configured to connect to aplurality of monitoring devices, and the stored script program specifiesa selected one or more of the plurality of monitoring devices from whichto collect the measurements.
 38. The apparatus according to claim 36,wherein the one or more monitoring devices comprise a device, multipledevices or a combination of devices selected from the group consistingof a sensor for measuring a blood-related physiological condition, asensor for measuring respiratory flow, a sensor for measuring electricalactivity of the individual, a sensor for measuring blood pressure, asensor for measuring a weight-related condition and a sensor formeasuring a heart-related condition.